Unexplained Infertility: What’s next?

June 10, 2020

RESOLVE: The National Infertility Association states that as many as 30% of couples struggling to get pregnant will be diagnosed with “Unexplained Infertility” or UI. While this can sound daunting at first, there is still lots of hope, but it all depends on your next steps.

If you are trying to get pregnant, and wondering when you need to seek additional help, visit our post When Should I Worry About Infertility, or schedule an appointment with our office so we can begin scheduling the first round of fertility tests.

What is Unexplained Infertility (UI)?

At first glance, it can seem like UI is a doctor’s way of saying, “we don’t know…” In truth, it is more complicated than that.

Unexplained infertility is diagnosed when a couple’s basic infertility tests come back “normal.” So, while the initial non-answer can seem quite frustrating, we recommend viewing it as good news because couples with UI have…

  • A regular menstrual cycle and proof of ovulation
  • Healthy egg reserves
  • Sperm that are within the normal count, have a healthy shape, and move well
  • Fallopian tubes that are free and clear of blockages (verified by an HSG)
  • A healthy uterus with no obvious abnormalities or structural issues that prevent implantation or a full-term pregnancy (diagnosed via hysteroscopy)
  • Healthy blood panels

…all of which are healthy fertility indicators.

If you review the above list and realize that your gynecologist or fertility specialist hasn’t performed testing or given conclusive results pertaining to each of those bullet points, you may have an incorrect diagnosis and should request the test results you are lacking.

Infertility Testing is Not Created Equal

Depending on where you go for fertility testing, you may not receive the same level of attention or testing. Baseline fertility testing should involve:

  • A review to ensure you know how to your ovulation and time intercourse accordingly
  • Routine physical and pelvic exam
  • A rigorous review of your menstrual/reproductive history
  • Full blood panels, including panels or reproductive hormone levels
  • AMH and FSH tests
  • Ultrasound, HSG, and Hysteroscopy imaging to get a picture of your inner-reproductive tract (looking for blocks or anatomical abnormalities blocking conception, implantation, or full-term development of a baby)
  • Sperm analysis
  • Genetic testing (you may be carrying a chromosomal or genetic abnormality that prevents conception or is causing you to miscarry)

Have you gone through all-of-the-above? If not, you need further testing.

What About Endometriosis (and laparoscopy)?

Interestingly, most fertility specialists consider laparoscopy a routine fertility test, but not all. This is a shame since endometriosis is a leading cause of infertility for women in the U.S. More moderate to severe cases of endometriosis are often verifiable via a woman’s list of symptoms (heavy periods, painful periods, long periods, shorter cycles, etc.).

However, there are plenty of women who have endometriosis and don’t know it, and even mild to moderate cases can affect fertility if endometrial deposits outside of the uterus muck up the ovulation, conception, implantation process.

If you aren’t getting pregnant, and laparoscopy hasn’t been a part of your fertility workup, speak to your doctor about scheduling the relevant tests.

Choose a Fertility Specialist Wisely

We physicians all have our specialties and favorites. For example, here at Women’s Health Associates, we are all crazy about taking care of women, their bodies, and their babies. However, within that realm, some of us are more in love with gynecology, while others are more excited about obstetrics.

Some of us have a knack for working with the teen population, while others prefer to spend as much time as possible serving the older-and-wiser senior population. The same is true for fertility specialists. If you’ve been through all of the testing we’ve mentioned above and the results were Unexplained Infertility, we recommend researching fertility specialists in your area, contacting them, and choosing one who specializes in that niche.

Those who spend more time and are more passionate about solving the mysteries and intricacies of UI are more likely to be successful when treating it. We’re fortunate here in the Kansas City area to have fabulous fertility specialists at the helm. Feel free to ask us for a referral.

Are you worried that you’re not getting pregnant as fast as you should? Are you interested in scheduling a preconception appointment to ensure your fertility is on track? Contact us here at Women’s Health Associates so we can begin to get to the bottom of things.